OBJECTIVE: To observe the effects of moderate aerobic exercise on migraine headache, to assess exercise-related changes in blood nitric oxide (NO) levels, and to examine the impact of such changes on migraine attacks. DESIGN: Controlled clinical trial. SETTING: School of Physical Therapy and Rehabilitation. SUBJECTS: Forty women with general migraine attending the Neurology Department of the Faculty of Medicine Faculty of Dokuz Eylul University. INTERVENTION: Patients were assigned alternately into two groups: exercise group undertaking 1 hour aerobic exercise three times weekly, and a control group. MAIN OUTCOME MEASURES: Patients were assessed before and after treatment using three clinical scales -- visual analogue scale for headache, Pain Disability Index and Quality of Life Scale -- and chemiluminescence analysis for plasma nitric oxide. RESULTS: After the eight-week therapy period, patient complaints concerning the intensity, frequency and duration of pain had decreased significantly in both groups; however, visual analogue scale scoring showed better pain relief in the exercised group than in the controls (from 8.8 +/- 1.7 to 4.0 +/- 1.4 and from 8.5 +/- 0.8 to 7.0 +/- 0.9 respectively). Quality of life measures also revealed better migraine relief in the exercised women than in those who received medical treatment only. Blood NO rose significantly from pre- to post-therapy in the exercised group, but the change was not significant in the control group. CONCLUSION: The study showed that regular long-term aerobic exercise reduced migraine pain severity, frequency and duration possibly due to increased nitric oxide production.

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